NCTV Episode 81

Continuing with the series of bitesize health tip videos which can be found here on my YouTube Channel, this episode, includes:

  • The common areas of injury
  • What causes them
  • How to treat them
  • Recovery time
  • Ways to prevent them

Transcript

If you’d prefer to read the content within, rather than watch the video, then feel free to read the transcript, as follows:-

Hello and welcome to NCTV Episode 81 and this one is about swimming injuries.

At the time of recording we’re at the end of June 22 and the Summer is always a popular time for people to be taking to the sea, pools, lakes, rivers, streams and even ponds to partake in one of the most popular sports in the world.

Swimming’s great and it’s considered a ‘low-impact’ sport due to the fact that the water supports a large percentage of your bodyweight. And exactly for that reason it’s often used in the rehabilitation of injuries to joints affected by weightbearing i.e., the back, hips, knees and ankles.

However, if you swim a lot for general fitness, or in competition, the risk of developing an overuse injury is high because of the repetitive and forceful nature of the shoulder revolutions as well as stress on the back, to hold you level in the water. In fact, 84% of regular swimmers suffer from overuse type injuries.

That doesn’t mean to say you should avoid swimming because the benefits do far outweigh the risk of injury. Some of these benefits might range from simply finding a quiet place for stress relieve to helping increase your general fitness or even to fulfil your desire to win competitions.

To highlight a few of the more common areas of injury that may cause you to sink rather than swim, these tend to be the shoulder, knee, neck and back.

Starting with ‘Swimmers Shoulder’ and this is the most common type of swimming injury. Given that swimmers annually perform hundreds of thousands of arm rotations it should be no surprise to learn that this type of work and frequency places a lot of stress on the shoulder muscles and joints. During one arm revolution, the shoulder is in a position of impingement (where it’s pinching structures) for 25% of the time. So you can see why multiplying that millions of times a year can lead to cumulative damage. Research has shown that shoulder injury is common across all strokes, at any age or level of swimming competition. So it doesn’t discriminate and this is probably due to the fact that with all strokes, between 50–90% of the power generated to propel you forward comes from the arms and shoulders.

Swimmers Shoulder can present with pain at the front or back of the shoulder which can travel either down the arm or up towards the neck during swimming or even lying on the side at night.

Aside from overuse it can also be caused by poor stroke technique, weak muscles, poor posture, stiff upper back and a lack of shoulder blade stability.

To treat it, manual therapy can help reduce the pain and improve the mobility, you can also do RICE and strapping, stretch the tight muscles, improve the mobility in the upper back, strengthen the weak shoulder muscles and correct your posture.

Onto the next common issue which is ‘Swimmers Knee’. This is more specific to breaststroke swimmers who usually develop pain on the inner side of the knee. Again, this is due to repeated loading of the knee joint in unnatural angles resulting in injury over time.

This can lead to swelling, sensitivity and stiffness.

Some of the causes may be weak muscles around the hip and buttocks, having a wide kick and stiff ankles.

Finally, neck and back pain which is also common in swimmers. These are often closely related to poor posture ‘on land.’ Swimming may not be the primary cause, the pain merely expresses itself in the water. Strong stabilising muscles on the front of the neck, as well as strong core muscles are crucial to ensure good alignment of the vertebrae and reduce strain on the joints. Identifying problems with your stroke is critical but remember to look elsewhere too and focus on the activities you do most during the day such as sitting, driving, lifting, carrying and computer work – if the ergonomics of these activities are not addressed you will battle to completely eliminate your pain.

Bilateral breathing can particularly help with neck pain and implementing a body roll can take some strain out of the back. Also, improving your rhythm and stroke alignment may be advisable. Outside of the water, you may also find spine mobilisation or manipulation helpful as well as dry needling or massage.

When it comes to rehabilitation, injuries can take up to 6 weeks to recover, even longer for those left untreated initially, which can require a prolonged rehabilitation, often 3 months or more. Shoulder surgery is not that successful in swimming injuries either. Often the exact cause of the pain is not identified and therefore not corrected. Post-surgical rehabilitation of the shoulder can take as long as 6 months. So, whatever you do, don’t leave a niggle and accept it as part of being a swimmer. Yes, you may have to stop swimming for a while, or at least reduce the intensity and duration of your sessions, but by doing this it will give you a chance to then address the problem before it turns into anything more serious.

Muscle imbalances are one of the main issues when it comes to swimming injuries. This is partly due to our daily routines consisting of activities like sitting for long periods at desks. Add to this the repetitive nature of swimming, certain muscles then become extremely well developed and strong while others get weak.

Having balanced muscle strength around a joint is crucial to support it, allow fluid motion, and maintain good alignment of the moving parts. Identifying muscle imbalances and applying strengthening or stretching exercises is key to preventing and managing an injury. This is where a physical therapist such as an osteopath like myself can help assess this and teach you appropriate exercises. Hands on mobilisation can also help to restore balance to tight, shortened muscles or restricted joints.

The second key step to preventing and managing an injury is identifying problems with your stroke that could be overloading or straining certain structures.

One final thing to mention is that, as with most sports, it is always a good idea to perform some prehab. This involves specific stretches and strengthening exercises on a regular basis as part of your daily routine or training, with the specific goal of preventing injury. Having regular massages and seeing a physical therapist to mobilise or loosen any stiff, tight structures may help you avoid developing a serious, debilitating injury.

That’s it for this week’s bitesize bit to help your health flourish. See you next time, bye bye.